Blood clot removal device, system, and method

ABSTRACT

The present invention relates to a method of implanting a blood clot removal device in a patient&#39;s body, by cutting the skin of the patient&#39;s body, dissecting an area of the patient&#39;s vascular system, placing the blot clot removal device at the dissected area, and connecting a blood flow passageway of the blood clot removal device to the patient&#39;s vascular system to allow circulation of the patient&#39;s blood through the blood flow passageway.

FIELD OF INVENTION

The present invention relates generally to a device and a systemimplantable in a blood flow passageway of a human or mammal patient forremoving blood clots, and more particularly to a system for removingblood clots in a vascular system of the patient, one example being aheart pump system. The invention also relates to a method of removingblood clots.

BACKGROUND

Today many implants are provided where the blood comes into contact withforeign material. All such implants have an associated risk oftriggering blood clots. Such clots may become loose and may createsevere damages at other parts of the body. Blood clots reaching thebrain are the most dangerous ones and implants in the heart region maytherefore be a first priority (although not limited to) of a blood clotremoval system. One example of such implants and one example of use forthe blood clot removal system may be heart help pumps. When a person hasheart failure, his or her heart can't pump enough blood to meet thebody's needs. In some cases, an advanced treatment such as a heart pumpmay be recommended. A heart pump takes over the function of one or bothof the heart's lower chambers, with the potential to improve yoursymptoms and quality of life. Once considered a last resort forprolonging life until a donated heart became available, heart pumps havebecome a possible long-term treatment for selected people with heartfailure.

A heart pump either takes over or assists the pumping role of the leftventricle—the heart's main pumping chamber. Part of the device, such asan electronic pump, is implanted in the heart and abdomen, and part,such as an electronic control unit, remains outside your body. An energysupply, such as a battery, can be provided either outside the body or beimplanted.

One tube carries blood from the left ventricle of the heart and into thepump. Another tube takes blood pumped from the device into the artery tobe circulated throughout the body.

A heart pump can be a lifesaving treatment. However, the potential risksare serious, including the risk of having blood clots in the arteriesleading from the heart.

Many other implants may be used together with the blood clot removalsystem. Basically any implant in contact with blood may be targets forthe invention.

SUMMARY OF THE INVENTION

An object of the present invention is to provide a device, a system, anda method for removing blood clots in the vascular system of a patient.

The invention is based on the realization that a blood clot removaldevice can be implanted in a patient instead of being external of thepatient.

According to a first aspect of the present invention there is provided ablood clot removal device for removing blood clots from the vascularsystem of a patient, the blood clot removal device being implantable inthe patient's body and comprising a blood flow passageway, a filterprovided in the blood flow passageway for filtering blood clots, and acleaning device for cleaning the filter. One possibility is to clean thefilter mechanically.

The cleaning device preferably is adapted to move blood clots away fromthe blood flow passageway to a place free inside the patient's body,where the body itself will take care of the blood clots. Alternatively,a collecting volume, such as a bag, is provided for collecting cleanedblood that has been mechanically cleaned from the filter. Most likelysuch a bag will then be placed inside the body.

In a preferred embodiment, the cleaning device is adapted to slice, pushor scratch away any clots from the filter, but the cleaning device canalso suck away any clots from the filter.

In one embodiment, the cleaning device comprises a first piston, withpreferably is provided with a first recess in an outer end portionthereof to collect blood clots removed from the filter. By providing thefirst piston with a plurality of channels for accommodating the filterin an extended position of the first piston, it can surround the filter,ensuring essentially complete removal of blood clots therefrom. This ispreferably effected if the first piston is movable in a directionperpendicular to the direction of the blood flow passageway.

The movement of the first piston can be controlled by a source ofpressurized air, ensuring rapid acceleration of the first piston andthereby short cleaning cycles. The movement of the first piston canalternatively be controlled by an electric motor, a solenoid or thelike.

The filter is of biocompatible material in order to avoid unnecessaryinterference with the blood environment.

In one embodiment, the blood clot removal device is used in a systemcomprising a heart pump connected to the blood flow passageway, whereina first tube preferably connects the heart pump to the left ventricle ofthe patient's heart and a second tube connects the heart pump connectedto the patient's aorta.

The filter preferably comprises a plurality of strips, which may beequally spaced to form a filter for blood clots. In order to achieve afiltering function, the distance between two adjacent strips ispreferably less than 2 millimeters, and even more preferably less than1.0 millimeter. The distance depends on which size blood clots you wantto avoid.

In one embodiment, a second piston is provided across the blood flowpassageway from the first piston, wherein the second piston is movablein a direction essentially perpendicular to the direction of the bloodflow passageway and spring biased in the direction of the first piston.If an outer end portion of the second piston is provided with a secondrecess, the first piston and the second piston cooperate to catch bloodclots for further removal. This further removal can be accomplished bymeans of a third piston, which is movable in a direction perpendicularto both the direction of the blood flow passageway and the direction ofmovement of the first piston and of the second piston.

In a preferred embodiment, the blood flow passageway of the blood clotremoval device has an essentially square cross-sectional shape, whichprovides for a laminated flow of the blood, particularly if the squareshape is combined with a filter comprising parallel strips.

The blood clot removal device is in a preferred embodiment insertable ina blood vessel of the patient, preferably via surgery.

The blood clot removal device can be adapted to be placed in thepatient's abdomen or thorax.

The blood clot removal device is preferably comprised in a system forremoving blood clots of a patient. This system can comprise a switch,preferably a subcutaneous switch being adapted to manually andnon-invasively control any function of the blood clot removal device.

The system for removing blood clots preferably comprises a hydraulicdevice having a hydraulic reservoir, wherein the blood clot removaldevice is adapted to non-invasively be regulated by manually pressingthe hydraulic reservoir.

A wireless remote control can non-invasively regulate any function ofthe blood clot removal device. Even more important any function of thedevice may be programmable by such a remote control.

Also, a wireless energy transmitter can non-invasively energize theblood clot removal device.

An energy source is preferably adapted to power the blood clot removaldevice. The energy source can comprise an internal energy source, suchas an internal energy source adapted to receive energy from an externalenergy source transmitting energy in a wireless mode. The internalenergy source can then be charged from the energy in the wireless mode.

The system preferably comprises a feedback device for sendinginformation from inside the patient's body to the outside thereof togive feedback information related to at least one functional parameterof the device or a physical parameter of the patient, thereby optimizingthe performance of the system. One preferred functional parameter of thedevice is correlated to the transfer of energy for charging the internalenergy source.

The system preferably comprises an operation device for operating theblood clot removal device. This operation device can comprise a motor ora pump, an electrically powered operation device, a hydraulic operationdevice, or an electric motor.

To improve the performance of the system for removing blood clots, aphysical parameter sensor, such as a pressure sensor, is provided forsensing a physical parameter of the patient. An internal control unitcan act in response to the physical parameter sensed by the sensor.

A functional parameter sensor sensing a functional parameter of theblood clot removal device can also be provided. An internal control unitacting in response to the functional parameter sensed by the sensor canalso be provided.

A method of using the system for removing blood clots is also provided,wherein at least one function of the blood clot removal device isregulated from outside the patient's body. The regulation is in apreferred embodiment non-invasively by manually pressing a subcutaneousswitch. In an alternative embodiment, non-invasively regulation areperformed by manually pressing a hydraulic reservoir connected to theblood clot removal device.

Alternatively, the system for removing blood clots comprises a wirelessremote control, wherein non-invasively regulation is performed usingsaid remote control.

In a preferred embodiment, the system for removing blood clots comprisesa wireless energy transmitter, wherein non-invasively regulation isperformed using said energy transmitter.

Preferably, an energy source is used for powering and adjusting anyfunction of the blood clot removal device. The energy source maycomprise an internal energy source, which preferably is associated withan external energy source adapted to transmit wireless energy. Energy ispreferably transmitted from the external energy source to charge theinternal energy source. Feedback information is preferably sent frominside the body to the outside thereof to give feed back related to thefunctional parameters of the device or physical parameters of thepatient. The functional parameter of the device is correlated to thetransfer of energy for charging the internal energy source.

In one embodiment, wireless energy is transmitted for powering theoperation device.

In a preferred embodiment, the method of using a system for removingblood clots comprises the steps of: implanting an implantable source ofenergy in the patient, providing an external source of energy,controlling the external source of energy to release wireless energy,charging non-invasively the implantable source of energy with thewireless energy, controlling the implantable source of energy fromoutside the patient's body, and releasing energy for use in connectionwith operation of the blood clot removal device. The wireless energy ispreferably stored in the implantable source of energy.

In another preferred embodiment, the method of using a system forremoving blood clots comprises the steps of: providing an externalsource of energy outside the patient's body, and controlling theexternal source of energy from outside the patient's body to releasewireless energy, and using released wireless energy for operating theoperation device. The wireless energy is preferably transformed intoelectrical energy inside the patient's body using an implantedenergy-transforming device and using the electrical energy whenoperating the blood clot removal device.

In one embodiment, the electrical energy is used directly in connectionwith operation of the blood clot removal device, as a transformingdevice transforms the wireless energy into the electrical energy.

In another embodiment, the external source of energy is controlling fromoutside the patient's body to release non-magnetic wireless energy, andreleased non-magnetic wireless energy is used for operating the bloodclot removal device.

In yet an alternative embodiment, the external source of energy iscontrolled from outside the patient's body to release electromagneticwireless energy, and released electromagnetic wireless energy is usedfor operating the blood clot removal device.

A method for placing a blood clot removal device, comprising a surgicalmethod via a laparoscopic abdominal approach, comprises the steps of:inserting a needle or tube like instrument into the abdomen of thepatient's body, using the needle or tube like instrument to fill thepatient's abdomen with gas thereby expanding the patient's abdominalcavity, placing at least two laparoscopic trocars in the patient's body,inserting a camera through one of the trocars into the patient'sabdomen, inserting at least one dissecting tool through a trocar anddissecting the intended placement area of the patient, placing at leastone blood clot removal device in any part of the vascular system in theabdomen, moving blood clots away from the vascular system postoperatively to a different part of the body, and powering the devicewith a source of energy. The blood clots can be moved either to a placethat is free in the abdomen, to a place that is free in the abdomen, orto a place that is encapsulated in a closed bag in the abdomen

The blood clot removal device is preferably programmable from outsidethe patients body. By adding the steps of sensing a physical parameterof the patient or a functional parameter of the device, and sendingsensing information to an internal control unit adapted for regulatingsaid blood clot removal device, performance is improved.

A method of placing a blood clot removal device, comprising a surgicalmethod via a laparoscopic thoraxial approach, comprises the steps of:inserting a needle or tube like instrument into the thorax of thepatients body, using the needle or tube like instrument to fill thethorax with gas thereby expanding the thoraxical cavity, placing atleast two laparoscopic trocars in the patient's body, inserting a camerathrough one of the trocars into the thorax, inserting at least onedissecting tool through a trocar and dissecting the intended area of thepatient, placing at least one blood clot removal device in any part ofthe vascular system in the thorax, moving blood clots away from vascularsystem post operatively to a different part of the body, and poweringthe device with a source of energy. The blood clots can be moved eitherto a place that is free in the thorax, to a place that is free in theabdomen, or to a place that is encapsulated in a closed bag in thethorax

The device is preferably programmed from outside the body of thepatient.

A method for surgically treating a patient needing a blood clot removaldevice in the vascular system in the patient's abdomen comprises thesteps of: cutting an opening in the patient's abdominal wall, dissectingan area of the vascular system, placing a blood clot removal deviceinside the vascular system, and suturing said abdominal wall. In oneembodiment, blood clots are moved away from the vascular system into anencapsulated closed bag in the patient's abdomen by means of the bloodclot removal device. In another embodiment, blood clots are moved to thefree abdomen.

A method for surgically treating a patient needing a blood clot removaldevice in the vascular system in the thorax comprises the steps of:cutting an opening in the thorax wall, dissecting the area of thevascular system, placing a blood clot removal device inside the vascularsystem, and suturing said thorax wall. A step of moving blood clots awayfrom the vascular system can comprise moving blood clots either to aplace that is free in the thorax, to a place that is free in theabdomen, or to a place that is encapsulated in a closed bag in thethorax

A method using an system for removing blood clots, for postoperativelyand non-invasively regulating the blood clot removal device, comprisesthe steps of: moving any blood clots, which have been accumulated in thevascular system of the patient's body, away from the vascular system,and placing the blood clots outside the vascular system. This can beaccomplished by an energy source, preferably repeatedly according to apre-programmed time-schedule. The steps of moving any blood clots awayfrom the vascular system and placing the blood clots outside thevascular system are preferably repeated and at least partly controlledby an internal control unit getting input from a sensor sensing anyphysical parameter of the patient or any functional parameter of thedevice. The accumulation of blood clots in the filter may be visualizedwith light sensors, sensors measuring any electrical parameter, anyblood flow measurement, pressure difference before and after the filteror any other kind of sensor.

An operation method for surgically placing a blood clot removal devicecomprises the steps of: cutting the patient's skin, dissecting aplacement area where to place the blood clot removal device inside thevascular system in the abdomen or thorax or retroperitoneal orsubcutaneously or any limb of the patient, placing the blood clotremoval device in the placement area, removing, postoperatively andnon-invasively without penetrating the patent's skin, any blood clotsfrom the vascular system to outside thereof, and using energy from anenergy source without any penetration through the patient's skin topower the blood clot removal device.

Further preferred embodiments are defined by the dependent claims.

BRIEF DESCRIPTION OF DRAWINGS

The invention is now described, by way of example, with reference to theaccompanying drawings, in which:

FIG. 1 is an overview of the body of a patient having an implanted heartpump.

FIG. 2 is a sectional view of a clot removal device according to theinvention.

FIG. 3 is a cross sectional view of the clot removal device of FIG. 2taken along the line III-III before a cleaning operation.

FIG. 4 is a sectional view of the clot removal device of FIG. 2 takenalong the line IV-IV.

FIG. 5 is a sectional view similar to that of FIG. 2 showing blood clotsbefore a clot removal operation.

FIG. 6 is a sectional view similar to that of FIG. 2 during a first stepof a clot removal operation.

FIG. 7 is a sectional view similar to that of FIG. 2 during a secondstep of a clot removal operation.

FIG. 8 is a sectional view similar to that of FIG. 2 during a third stepof a clot removal operation.

FIG. 9 is a cross sectional view similar to that of FIG. 3 but during acleaning operation.

FIG. 10 is a sectional view of the clot removal device of FIG. 8 takenalong the line X-X showing a clot ejection piston before ejection ofclots.

FIG. 11 is a view similar to that of FIG. 9 but after ejection of clots.

FIG. 12 is an overall view of a clot removal system according to theinvention.

FIG. 13 is a schematic diagram of the system of FIG. 12.

FIGS. 14-29 show various embodiments based on the system of FIG. 13.

FIGS. 30a and 30b are views of a filter cassette.

FIGS. 31a and 31b are views of a filter cassette.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

In the following a detailed description of preferred embodiments of thepresent invention will be given. In the drawing figures, like referencenumerals designate identical or corresponding elements throughout theseveral figures. It will be appreciated that these figures are forillustration only and are not in any way restricting the scope of theinvention. Thus, any references to direction, such as “up” or “down”,are only referring to the directions shown in the figures. Also, anydimensions etc. shown in the figures are for illustration purposes.

FIG. 1 shows a patient 1 having an implanted heart pump 2. The implantedheart pump 2 is connected to the left ventricle 3 a of the patient'sheart 3 by means of a first tube 2 a. The heart pump 2 is also connectedto the aorta, generally designated 4, of the patient 1 by means of asecond tube 2 b. In this way, during operation the heart pumpsupplements or replaces the blood pumping operation of the patient'sheart 3.

A blood clot removal device 10 according to the invention is shownprovided in the second tube 2 b of the heart pump 2, i.e., in the tubeleading to the aorta 4 of the patient 1. This means that part of theblood flow passageway provided by the second tube 2 b is replaced by ablood flow passageway in the blood clot removal device 10. The bloodclot removal device 10 is thus an artificial device insertable in anartificial blood vessel of the patient. The function of the clot removaldevice is to remove any blood clots in the blood transported by thesecond tube 2 b. These blood clots are preferably moved to a place freeinside the body of the patient. However, they could alternatively becollected in a collecting volume, such as a bag 10 a connected to theblood clot removal device 10 for subsequent removal or storage. Apreferred storage capacity of the bag 10 a can be more than 100milliliters, for example. The blood clot removal device is an artificialdevice but could be inserted directly into a blood vessel of the patientor connected between two ends of a blood vessel.

The clot removal device is preferably insertable in a blood flowpassageway of the patient via surgery and is placed in the patient'sabdomen or thorax or cephalic or neck region or retroperitoneal or anylimb of the patient.

The design of a first preferred embodiment of the blood clot removaldevice 10 will now be described in detail, with reference to FIGS. 2-4.FIG. 2 shows a sectional view wherein the blood clot removal device 10is provided in the blood flow passageway provided by the second tube 2b. A filter 12 is provided across the blood flow passageway 14 formed ina housing 11 with the function of stopping potential blood clots broughtforward in the second tube 2 b by the blood flow, indicated by arrows inthe figure. In this preferred embodiment, the filter 12 comprises aplurality of preferably equally spaced strips 12 a of some suitablematerial, such as biocompatible metal or plastic. These strips 12 a arepreferably arranged mutual parallel.

The distance between two adjacent strips is small enough to stop anyblood clots. Thus, the distance is preferably less than 2 millimeters,and even more preferably less than 1.0 millimeters, but if the goal isto protect the brain from larger clots only the distance could belarger. Although the blood flow passageway 14 in the preferredembodiment has an essentially square cross-sectional shape, it will berealized that it can take any suitable shape, such as rectangular orcircular.

By providing a plurality of strips 12 a as a filter across the bloodflow passageway 14, a laminar blood flow is achieved downstream of thefilter, which is advantageous in a blood clot preventing perspective.The blood flow configuration can be further enhanced by giving theplurality of strips 12 a a desired cross-sectional shape, although therectangular shape shown in FIG. 4 will be adequate for most purposes.

A first piston 16 is provided movable in a direction essentiallyperpendicular to the direction of the blood flow passageway 14, i.e.,essentially perpendicular to the direction of the blood flow. This firstpiston 16 is driven by some suitable actuator means, such as pressurizedair, a solenoid arrangement, an electrical servo motor or the like. Amotor could be used to build up a stored power that could be releasedvery fast, one example being a spring. In the preferred embodiment,pressurized air acts as the actuator means, since by latching the pistonby means of a suitable latching means for the piston, building up theair pressure, and subsequently releasing the piston, very high speed ofthe piston is achieved, with enables short cleaning times of the filter.

The outer end portion of the first piston 16, i.e., the end portionfacing the blood flow passageway 14, is essentially flush with the wallof the blood flow passageway in a non-active state of the blood clotremoval device 10. Also, the outer end portion is provided with aconcave portion or recess 16 a (exaggerated in the figures) in order toact as a blood clot capturing means, as will be explained below.

The strike range of the first piston 16 is such that it extends all wayacross the blood flow passageway 14, as will be explained below withreference to FIGS. 5-8. A number of channels 16 b corresponding to thenumber of strips 12 a is provided in the first piston 16 to accommodatethe strips when the first piston is in an extended position.

The first piston 16 is also provided with a plurality of through holes17 in the direction of the blood flow passageway. These through holeswill allow blood to flow through the blood flow passageway also during acleaning operation, as will be explained below with reference to FIG. 9.

A second piston 18 is provided across the blood flow passageway 14 fromthe first piston 16. Also this second piston 18 is movable in adirection essentially perpendicular to the direction of the blood flowpassageway 14 and is biased in the direction thereof by means of aspring 18 a, for example. Likewise, the outer end portion of the secondpiston is provided with a recess 18 b similar to the recess 16 a of thefirst piston 16.

The first and second pistons 16, 18, are sealed to the housing 11 bymeans of a respective sealing 20, such as an O sealing.

A preferred embodiment of the method according to the invention will nowbe described with reference to FIGS. 5-8, showing different operationalsteps of the above-described device. FIG. 5 is a view similar to that ofFIG. 2. However, this figures shows the blood clot removal device 10during operation, wherein blood clots, generally designated 22, haveassembled on the filter 12.

In FIG. 6, the first piston 16 has moved linearly from the retractedstarting position shown FIG. 5 to an extended position, wherein theouter end portion thereof is in contact with the second piston 18. Dueto the recess 16 a in the outer end of the first piston 16, the bloodclots 22 have been assembled in the recess 16 a, whereby they have beenbrought with the first piston 16 during the movement thereof. In thestep shown in FIG. 6, the blood clots are confined in the recess 16 abetween the first and second pistons 16, 18.

By moving the first piston 16 an additional distance from the positionshown in FIG. 6, the second piston 18 is pushed against the force of thespring 18 a to a fully retracted position, see FIG. 7. The plurality ofstrips 12 a is in this position fully received in a respective channel16 b in the first piston. It is seen that the outer ends of the firstand second pistons define an unobstructed cavity in which the bloodclots are confined. It is thereby possible to remove these by somesuitable means. One such means could be a third piston 24, which ismovable in a direction perpendicular to both the direction of the bloodflow passageway 14 and the direction of movement of the first and secondpistons 16, 18. This third piston, the movement of which could becontrolled by means of pressurized air, a solenoid, an electric motoretc., scrapes off the blood clots collected by the first piston 16 andmoves them to a place outside of the blood clot removal device 10 andthe blood flow passageway 14.

FIG. 9 shows a side view of the first piston 16 in a fully extendedposition, i.e., corresponding to the view of FIG. 8. It is here seenthat in this position the through holes 17 will be aligned with theblood flow passageway 14, thereby allowing blood to flow therethroughalso during cleaning of the filter 12.

FIG. 10 shows a cross-sectional view taken along line X-X of FIG. 8. Itis here seen that the third piston 24 collects the blood clots 22 duringa downward movement, indicated by an arrow in the figure. The clots areejected from the blood clot removal device 10 when the third piston 24has reached its lower end position, shown in FIG. 11.

Again with reference to FIG. 7, it will be realized that pressurized aircan be used for ejecting the collected blood clots from the cavityformed by the first piston 16 and the second piston 18.

A clot removal system, generally designated 28 and comprising a clotremoval device as described above will now be described with referenceto FIGS. 12-25.

The system of FIG. 12 comprises a blood clot removal device 10 placed inthe abdomen of the patient. An internal energy source in the form of animplanted energy transforming device 30 is adapted to supply energyconsuming components of the blood clot removal device 10 with energy viaa power supply line 32. An external energy transmission device 34includes a wireless remote control transmitting a wireless signal, whichis received by a signal receiver incorporated in the implanted energytransforming device 30. The implanted energy transforming device 30transforms energy from the signal into electric energy which is suppliedvia the power supply line 32.

The system of FIG. 12 is shown in a more generalized block diagram formin FIG. 13, wherein the patient's skin 36, generally shown by a verticalline, separates the interior of the patient to the right of the linefrom the exterior to the left of the line.

FIG. 14 shows an embodiment of the invention identical to that of FIG.13, except that a reversing device in the form of an electric switch 38operable by polarized energy also is implanted in the patient forreversing the blood clot removal device 10. The wireless remote controlof the external energy transmission device 34 transmits a wirelesssignal that carries polarized energy and the implanted energytransforming device 30 transforms the wireless polarized energy into apolarized current for operating the electric switch 38. When thepolarity of the current is shifted by the implanted energy transformingdevice 30 the electric switch 38 reverses the function performed by theblood clot removal device 10.

FIG. 15 shows an embodiment of the invention identical to that of FIG.13, except that an operation device 40 implanted in the patient forregulating the blood clot removal device 10 is provided between theimplanted energy transforming device 30 and the blood clot removaldevice 10. This operation device can be in the form of a motor 40, suchas an electric servo motor. The motor 40 is powered with energy from theimplanted energy transforming device 30, as the remote control of theexternal energy transmission device 34 transmits a wireless signal tothe receiver of the implanted energy transforming device 30.

FIG. 16 shows an embodiment of the invention identical to that of FIG.13, except that it also comprises an operation device is in the form ofan assembly 42 including a motor/pump unit 78 and a fluid reservoir 46is implanted in the patient. In this case the blood clot removal device10 is hydraulically operated, i.e. hydraulic fluid is pumped by themotor/pump unit 44 from the fluid reservoir 46 through a conduit 48 tothe blood clot removal device 10 to operate the clot removal device, andhydraulic fluid is pumped by the motor/pump unit 44 back from the bloodclot removal device 10 to the fluid reservoir 46 to return the clotremoval device to a starting position. The implanted energy transformingdevice 30 transforms wireless energy into a current, for example apolarized current, for powering the motor/pump unit 44 via an electricpower supply line 50.

Instead of a hydraulically operated blood clot removal device 10, it isalso envisaged that the operation device comprises a pneumatic operationdevice. In this case, pressurized air can be used for regulation and thefluid reservoir is replaced by an air chamber and the fluid is replacedby air.

FIG. 17 shows an embodiment of the invention comprising the externalenergy transmission device 34 with its wireless remote control, theblood clot removal device 10, in this case hydraulically operated, andthe implanted energy transforming device 30, and further comprising ahydraulic fluid reservoir 52, a motor/pump unit 44 and an reversingdevice in the form of a hydraulic valve shifting device 54, allimplanted in the patient. The motor of the motor/pump unit 44 is anelectric motor. In response to a control signal from the wireless remotecontrol of the external energy transmission device 34, the implantedenergy transforming device 30 powers the motor/pump unit 44 with energyfrom the energy carried by the control signal, whereby the motor/pumpunit 44 distributes hydraulic fluid between the hydraulic fluidreservoir 52 and the blood clot removal device 10. The remote control ofthe external energy transmission device 34 controls the hydraulic valveshifting device 54 to shift the hydraulic fluid flow direction betweenone direction in which the fluid is pumped by the motor/pump unit 44from the hydraulic fluid reservoir 52 to the blood clot removal device10 to operate the clot removal device, and another opposite direction inwhich the fluid is pumped by the motor/pump unit 44 back from the bloodclot removal device 10 to the hydraulic fluid reservoir 52 to return theclot removal device to a starting position.

FIG. 18 shows an embodiment of the invention identical to that of FIG.13, except that an internal control unit 56 controlled by the wirelessremote control of the external energy transmission device 34, anaccumulator 58 and a capacitor 60 also are implanted in the patient. Theinternal control unit 56 arranges storage of electric energy receivedfrom the implanted energy transforming device 30 in the accumulator 58,which supplies energy to the blood clot removal device 10. In responseto a control signal from the wireless remote control of the externalenergy transmission device 34, the internal control unit 56 eitherreleases electric energy from the accumulator 58 and transforms thereleased energy via power lines 62 and 64, or directly transformselectric energy from the implanted energy transforming device 30 via apower line 66, the capacitor 60, which stabilizes the electric current,a power line 68 and the power line 64, for the operation of the bloodclot removal device 10.

The internal control unit is preferably programmable from outside thepatient's body. In a preferred embodiment, the internal control unit isprogrammed to regulate the blood clot removal device 10 to remove anyblood clots from the vascular system and place the blood clots outsidethe vascular system repeatedly according to a pre-programmedtime-schedule.

In accordance with an alternative, the capacitor 60 in the embodiment ofFIG. 18 may be omitted. In accordance with another alternative, theaccumulator 58 in this embodiment may be omitted.

FIG. 19 shows an embodiment of the invention identical to that of FIG.13, except that a battery 70 for supplying energy for the operation ofthe blood clot removal device 10 and an electric switch 72 for switchingthe operation of the blood clot removal device 10 also are implanted inthe patient. The electric switch 72 is operated by the energy suppliedby the implanted energy transforming device 30 to switch from an offmode, in which the battery 70 is not in use, to an on mode, in which thebattery 70 supplies energy for the operation of the blood clot removaldevice 10.

FIG. 20 shows an embodiment of the invention identical to that of FIG.19, except that an internal control unit 56 controllable by the wirelessremote control of the external energy transmission device 34 also isimplanted in the patient. In this case, the electric switch 72 isoperated by the energy supplied by the implanted energy transformingdevice 30 to switch from an off mode, in which the wireless remotecontrol is prevented from controlling the internal control unit 56 andthe battery is not in use, to a standby mode, in which the remotecontrol is permitted to control the internal control unit 56 to releaseelectric energy from the battery 70 for the operation of the blood clotremoval device 10.

FIG. 21 shows an embodiment of the invention identical to that of FIG.20, except that an accumulator 58 is substituted for the battery 70 andthe implanted components are interconnected differently. In this case,the accumulator 58 stores energy from the implanted energy transformingdevice 30. In response to a control signal from the wireless remotecontrol of the external energy transmission device 34, the internalcontrol unit 56 controls the electric switch 72 to switch from an offmode, in which the accumulator 58 is not in use, to an on mode, in whichthe accumulator 58 supplies energy for the operation of the blood clotremoval device 10.

FIG. 22 shows an embodiment of the invention identical to that of FIG.21, except that a battery 70 also is implanted in the patient and theimplanted components are interconnected differently. In response to acontrol signal from the wireless remote control of the external energytransmission device 34, the internal control unit 56 controls theaccumulator 58 to deliver energy for operating the electric switch 72 toswitch from an off mode, in which the battery 70 is not in use, to an onmode, in which the battery 70 supplies electric energy for the operationof the blood clot removal device 10.

Alternatively, the electric switch 72 may be operated by energy suppliedby the accumulator 58 to switch from an off mode, in which the wirelessremote control is prevented from controlling the battery 70 to supplyelectric energy and is not in use, to a standby mode, in which thewireless remote control is permitted to control the battery 70 to supplyelectric energy for the operation of the blood clot removal device 10.

FIG. 23 shows an embodiment of the invention identical to that of FIG.19, except that a motor 40, a mechanical reversing device in the form ofa gear box 74, and an internal control unit 56 for controlling the gearbox 74 also are implanted in the patient. The internal control unit 56controls the gear box 74 to reverse the function performed by the bloodclot removal device 10 (mechanically operated).

FIG. 24 shows an embodiment of the invention identical to that of FIG.22 except that the implanted components are interconnected differently.Thus, in this case the internal control unit 56 is powered by thebattery 70 when the accumulator 58, suitably a capacitor, activates theelectric switch 72 to switch to an on mode. When the electric switch 72is in its on mode the internal control unit 56 is permitted to controlthe battery 70 to supply, or not supply, energy for the operation of theblood clot removal device 10.

FIG. 25 schematically shows conceivable combinations of implantedcomponents of the apparatus for achieving various communication options.Basically, there are the blood clot removal device 10, the internalcontrol unit 56, motor/pump unit 44, and the external energytransmission device 34 including the external wireless remote control.As already described above the wireless remote control transmits acontrol signal which is received by the internal control unit 56, whichin turn controls the various implanted components of the apparatus.

A feedback device, preferably in the form of a sensor 76, may beimplanted in the patient for sensing a physical parameter of thepatient, such as the pressure in a blood vessel. The internal controlunit 56, or alternatively the external wireless remote control of theexternal energy transmission device 34, may control the blood clotremoval device 10 in response to signals from the sensor 76. Atransceiver may be combined with the sensor 76 for sending informationon the sensed physical parameter to the external wireless remotecontrol. The wireless remote control may comprise a signal transmitteror transceiver and the internal control unit 56 may comprise a signalreceiver or transceiver. Alternatively, the wireless remote control maycomprise a signal receiver or transceiver and the internal control unit56 may comprise a signal transmitter or transceiver. The abovetransceivers, transmitters and receivers may be used for sendinginformation or data related to the blood clot removal device 10 frominside the patient's body to the outside thereof.

Alternatively, the sensor 76 may be arranged to sense a functionalparameter of the blood clot removal device 10.

Where the motor/pump unit 44 and battery 70 for powering the motor/pumpunit 44 are implanted, the battery 70 may be equipped with a transceiverfor sending information on the condition of the battery 70.

FIG. 26 shows an alternative embodiment wherein the blood clot removaldevice 10 is regulated from outside the patient's body. The clot removalsystem 28 comprises a blood clot removal device 10 connected to abattery 70 via a subcutaneous switch 80. Thus, the regulation of theblood clot removal device 10 is performed non-invasively by manuallypressing the subcutaneous switch, whereby the operation of the bloodclot removal device 10 is switched on and off. It will be appreciatedthat the shown embodiment is a simplification and that additionalcomponents, such as an internal control unit, can be added to the clotremoval system.

FIG. 27 shows an alternative embodiment, wherein the clot removal system28 comprises a blood clot removal device 10 in fluid connection with ahydraulic fluid reservoir 52. Non-invasive regulation is performed bymanually pressing the hydraulic reservoir connected to the blood clotremoval device 10.

A further embodiment of a system according to the invention comprises afeedback device for sending information from inside the patient's bodyto the outside thereof to give feedback information related to at leastone functional parameter of the clot removal device or system or aphysical parameter of the patient, thereby optimizing the performance ofthe system.

One preferred functional parameter of the device is correlated to thetransfer of energy for charging the internal energy source.

In FIG. 28, an arrangement is schematically illustrated for supplying anaccurate amount of energy to a clot removal system 28 implanted in apatient, whose skin 36 is indicated by a vertical line. A blood clotremoval device 10 is connected to an implanted energy transformingdevice 30, likewise located inside the patient, preferably just beneaththe patient's skin 36. Generally speaking, the implanted energytransforming device 30 may be placed in the abdomen, thorax, musclefascia (e.g. in the abdominal wall), subcutaneously, or at any othersuitable location. The the implanted energy transforming device 30 isadapted to receive wireless energy E transmitted from an external energysource 34 a provided in the external energy transmission device 34located outside the patient's skin 36 in the vicinity of the implantedenergy transforming device 30.

As is well known in the art, the wireless energy E may generally betransferred by means of any suitable Transcutaneous Energy Transfer(TET) device, such as a device including a primary coil arranged in theexternal energy source 34 a and an adjacent secondary coil arranged inthe implanted energy transforming device 30.

When an electric current is fed through the primary coil, energy in theform of a voltage is induced in the secondary coil which can be used tooperate a clot removal device, e.g. after storing the incoming energy inan energy storing device or accumulator, such as a battery or acapacitor. However, the present invention is generally not limited toany particular energy transfer technique, TET devices or energy storingdevices, and any kind of wireless energy may be used.

The amount of transferred energy can be regulated by means of anexternal control unit 34 b controlling the external energy source 34 abased on the determined energy balance, as described above. In order totransfer the correct amount of energy, the energy balance and therequired amount of energy can be determined by means of an internalcontrol unit 56 connected to the blood clot removal device 10. Theinternal control unit 56 may thus be arranged to receive variousmeasurements obtained by suitable sensors or the like, not shown,measuring certain characteristics of the blood clot removal device 10,somehow reflecting the required amount of energy needed for properoperation of the blood clot removal device 10. Moreover, the currentcondition of the patient may also be detected by means of suitablemeasuring devices or sensors, in order to provide parameters reflectingthe patient's condition. Hence, such characteristics and/or parametersmay be related to the current state of the blood clot removal device 10,such as power consumption, operational mode and temperature, as well asthe patient's condition reflected by, e.g., body temperature, bloodpressure, heartbeats and breathing.

Furthermore, an energy storing device or accumulator 58 may optionallybe connected to the implanted energy transforming device 30 foraccumulating received energy for later use by the blood clot removaldevice 10. Alternatively or additionally, characteristics of such anaccumulator, also reflecting the required amount of energy, may bemeasured as well. The accumulator may be replaced by a battery, and themeasured characteristics may be related to the current state of thebattery, such as voltage, temperature, etc. In order to providesufficient voltage and current to the blood clot removal device 10, andalso to avoid excessive heating, it is clearly understood that thebattery should be charged optimally by receiving a correct amount ofenergy from the implanted energy transforming device 30, i.e. not toolittle or too much. The accumulator may also be a capacitor withcorresponding characteristics.

For example, battery characteristics may be measured on a regular basisto determine the current state of the battery, which then may be storedas state information in a suitable storage means in the internal controlunit 56. Thus, whenever new measurements are made, the stored batterystate information can be updated accordingly. In this way, the state ofthe battery can be “calibrated” by transferring a correct amount ofenergy, so as to maintain the battery in an optimal condition.

Thus, the internal control unit 56 is adapted to determine the energybalance and/or the currently required amount of energy, (either energyper time unit or accumulated energy) based on measurements made by theabove-mentioned sensors or measuring devices on the blood clot removaldevice 10, or the patient, or an energy storing device if used, or anycombination thereof. The internal control unit 56 is further connectedto an internal signal transmitter 82, arranged to transmit a controlsignal reflecting the determined required amount of energy, to anexternal signal receiver 34 c connected to the external control unit 34b. The amount of energy transmitted from the external energy source 34 amay then be regulated in response to the received control signal.

Alternatively, sensor measurements can be transmitted directly to theexternal control unit 34 b wherein the energy balance and/or thecurrently required amount of energy can be determined by the externalcontrol unit 34 b, thus integrating the above-described function of theinternal control unit 56 in the external control unit 34 b. In thatcase, the internal control unit 56 can be omitted and the sensormeasurements are supplied directly to the internal signal transmitter 82which sends the measurements over to the external signal receiver 34 cand the external control unit 34 b. The energy balance and the currentlyrequired amount of energy can then be determined by the external controlunit 34 b based on those sensor measurements.

Hence, the present solution employs the feed back of informationindicating the required energy, which is more efficient than previoussolutions because it is based on the actual use of energy that iscompared to the received energy, e.g. with respect to the amount ofenergy, the energy difference, or the energy receiving rate as comparedto the energy rate used by the clot removal device. The clot removaldevice may use the received energy either for consuming or for storingthe energy in an energy storage device or the like. The differentparameters discussed above would thus be used if relevant and needed andthen as a tool for determining the actual energy balance. However, suchparameters may also be needed per se for any actions taken internally tospecifically operate the clot removal device.

The internal signal transmitter 82 and the external signal receiver 34 cmay be implemented as separate units using suitable signal transfermeans, such as radio, IR (Infrared) or ultrasonic signals.Alternatively, the internal signal transmitter 82 and the externalsignal receiver 34 c may be integrated in the implanted energytransforming device 30 and the external energy source 34 a,respectively, so as to convey control signals in a reverse directionrelative to the energy transfer, basically using the same transmissiontechnique. The control signals may be modulated with respect tofrequency, phase or amplitude.

To conclude, the energy supply arrangement illustrated in FIG. 28 mayoperate basically in the following manner. The energy balance is firstdetermined by the internal control unit 56. A control signal reflectingthe required amount of energy is also created by the internal controlunit 56, and the control signal is transmitted from the internal signaltransmitter 82 to the external signal receiver 34 c. Alternatively, theenergy balance can be determined by the external control unit 34 binstead depending on the implementation, as mentioned above. In thatcase, the control signal may carry measurement results from varioussensors. The amount of energy emitted from the external energy source 34a can then be regulated by the external control unit 34 b, based on thedetermined energy balance, e.g. in response to the received controlsignal. This process may be repeated intermittently at certain intervalsduring ongoing energy transfer, or may be executed on a more or lesscontinuous basis during the energy transfer.

The amount of transferred energy can generally be regulated by adjustingvarious transmission parameters in the external energy source 34 a, suchas voltage, current, amplitude, wave frequency and pulsecharacteristics.

A method is thus provided for controlling transmission of wirelessenergy supplied to an electrically operable clot removal deviceimplanted in a patient. The wireless energy E is transmitted from anexternal energy source located outside the patient and is received by aninternal energy receiver located inside the patient, the internal energyreceiver being connected to the clot removal device for directly orindirectly supplying received energy thereto. An energy balance isdetermined between the energy received by the internal energy receiverand the energy used for the clot removal device. The transmission ofwireless energy E from the external energy source is then controlledbased on the determined energy balance.

A system is also provided for controlling transmission of wirelessenergy supplied to an electrically operable clot removal deviceimplanted in a patient. The system is adapted to transmit the wirelessenergy E from an external energy source located outside the patientwhich is received by an implanted energy transforming device locatedinside the patient, the implanted energy transforming device beingconnected to the clot removal device for directly or indirectlysupplying received energy thereto. The system is further adapted todetermine an energy balance between the energy received by the implantedenergy transforming device and the energy used for the clot removaldevice, and control the transmission of wireless energy E from theexternal energy source, based on the determined energy balance.

The functional parameter of the device is correlated to the transfer ofenergy for charging the internal energy source.

In yet an alternative embodiment, the external source of energy iscontrolled from outside the patient's body to release electromagneticwireless energy, and released electromagnetic wireless energy is usedfor operating the blood clot removal device.

In another embodiment, the external source of energy is controlling fromoutside the patient's body to release non-magnetic wireless energy, andreleased non-magnetic wireless energy is used for operating the bloodclot removal device.

Those skilled in the art will realize that the above various embodimentsaccording to FIGS. 13-29 could be combined in many different ways. Forexample, the electric switch 38 operated polarized energy could beincorporated in any of the embodiments of FIGS. 15, 18-24, the hydraulicvalve shifting device 54 could be incorporated in the embodiment of FIG.16, and the gear box 74 could be incorporated in the embodiment of FIG.15.

Wireless transfer of energy for operating the clot removal device hasbeen described to enable non-invasive operation. It will be appreciatedthat the clot removal device can be operated with wire bound energy aswell. On such example is shown in FIG. 29, wherein an external switch 84is interconnected between the external energy source 34 a and anoperation device, such as an electric motor regulating the blood clotremoval device 10, by means of power lines 86 and 88. An externalcontrol unit 34 b controls the operation of the external switch toeffect proper operation of the blood clot removal device 10.

Methods relating to the above described clot removal device and systemwill now be described in detail.

The clot removal device can be placed surgically in the patient via alaparoscopic abdominal approach. First, a tube is inserted into theabdomen of the patient's body and this tube is used to fill thepatient's abdomen with gas, thereby expanding the patient's abdominalcavity. At least two laparoscopic trocars are then placed in thepatient's body, where after a camera is inserted through one of thetrocars into the patient's abdomen. At least one dissecting tool isinserted through a trocar and dissection is performed at two intendedareas of the patient. A clot removal device is placed in any part of thevascular system in the abdomen.

Alternatively, the clot removal device can be placed in the patient'sthorax. Thus, a tube is inserted into the thorax of the patient's bodyand this tube is used to fill the patient's thorax with gas, therebyexpanding the patient's thoraxical cavity. At least two laparoscopictrocars are then placed in the patient's body, where after a camera isinserted through one of the trocars into the patient's thorax. At leastone dissecting tool is inserted through a trocar and dissection isperformed at two intended areas of the patient. A clot removal device isplaced in any part of the vascular system in the thorax.

An operation method for surgically placing a clot removal device startswith cutting the patient's skin and dissecting a placement area where toplace the clot removal device inside the vascular system in the abdomenor thorax or retroperitoneal or subcutaneously or any limb of thepatient. When a suitable place has been found, the clot removal deviceis placed in the placement area. The clot removal device can then beused postoperatively and non-invasively without penetrating the patent'sskin for removing any blood clots from the vascular system to outsidethereof, while using energy from an energy source without anypenetration through the patient's skin to power the blood clot removaldevice.

A method for surgically treating a patient needing a blood clot removaldevice in the vascular system in the patient's abdomen preferablycomprises cutting an opening in the patient's abdominal wall and thendissecting an area of the vascular system. A clot removal device isplaced inside the vascular system, and the abdominal wall is sutured. Inone embodiment, blood clots are moved away from the vascular system intoan encapsulated closed bag in the patient's abdomen by means of theblood clot removal device. In another embodiment, blood clots are movedto the free abdomen.

Alternatively, a method for surgically treating a patient needing ablood clot removal device in the vascular system in the thorax comprisescutting an opening in the thorax wall and then dissecting the area ofthe vascular system. A clot removal device is placed inside the vascularsystem, and the thorax wall is sutured. A step of moving blood clotsaway from the vascular system can comprise moving blood clots either toa place that is free in the thorax, to a place that is free in theabdomen, or to a place that is encapsulated in a closed bag in thethorax.

In one embodiment, a method of using a system for removing blood clotscomprises implanting an implantable source of energy, such as animplanted energy transforming device 30 and an accumulator 58, in thepatient. An external source of energy, such as an external energytransmission device 34, is provided for providing energy to the system.This external source of energy is operated to release wireless energy,thereby non-invasively charging the implantable source of energy withthe wireless energy, while controlling the implantable source of energyfrom outside the patient's body. In connection with operation of theclot removal device, energy is releasing. The wireless energy ispreferably stored in the implantable source of energy.

During operation, the system for removing blood clots postoperativelyand non-invasively regulates the clot removal device. Any blood clots,which have been accumulated in the vascular system of the patient'sbody, are moved away from the vascular system and are then placedoutside the vascular system. This can be accomplished by an energysource, preferably repeatedly according to a pre-programmedtime-schedule. The movement of any blood clots away from the vascularsystem and placement of the blood clots outside the vascular system arepreferably repeated and at least partly controlled by an internalcontrol unit getting input from a sensor sensing any physical parameterof the patient or any functional parameter of the device.

Preferred embodiments of a clot removal device, a system comprising aclot removal device, and a method according to the invention have beendescribed. A person skilled in the art realizes that these could bevaried within the scope of the appended claims.

The blood clot removal device has been described as an artificial deviceinsertable in an artificial blood vessel of the patient. Alternatively,the blood clot removal device is an artificial device adapted to beplaced between two open ends of a blood vessel of the patient or beplaced inside or attached to a blood vessel via surgery.

The blood clot removal device has been described to be placed in thepatient's abdomen or thorax. It could also be adapted to be placed inthe patient's retroperitoneal region or cephalic or neck region or anylimb of the patient.

The filter in the blood clot removal device may be exchanged andreplaced with a new fresh filter when it becomes dirty. One embodimentof such a solution is described below in FIGS. 30 and 31. There areobvious many different solutions to solve the same problems.

In FIG. 30a a cassette 127 for holding filters is shown. The cassette 27comprises a revolving cylinder 129 having segments 130 each holding afilter. The cylinder 129 is tightly sealed between two supports 131holding the cylinder 129 in place and providing a tight sealing.Preferable are the contacting surfaces made of ceramics to seal thesurfaces with fine tolerances. The blood flow passageway of animplantable blood clot removal apparatus passes through the cassette127. The cassette is driven by a motor 133 causing the cylinder 129 torevolve at suitable times. Preferable the filter is designed to move anycollected blood clots out from the blood flow passageway together withrevolving filter, when the filter leaves the blood flow passageway to bereplaced with a new filter. The filter may be any kind of filterpreferable with a space for the collected blood clots or blood clotsadherent to the filter itself. Such a space to both the sealing plateswhen rotating, should preferable be larger before the filter seen in theblood flow passageway. The motor is powered by a power supply 123 b. Thepower supply can be a power supply like the power supplies 123 or 123 a.In accordance with one embodiment the power supplies 123, 123 a and 123b is the one and same power supply. As with the power supplies 123 and123 a, the power supply 123 b can receive wireless energy in a suitableform, including but not limited to inductive energy ultrasonic energy,light energy or any other form of wireless energy set out above. Theenergy is supplied by an external wireless energy transmitter 6 adaptedto transmit energy through the skin 5 of a patient having the cassette127 implanted. The power supply 132 b can also comprise a control unitas described above for controlling the revolving cassette 127. Thecontrol unit can provide feedback to the outside and receive input datafrom an external transceiver 7 in a manner similar to the control unitused in conjunction with control of the pump.

In FIG. 30b the cassette 127 is shown from the side with the supports131 and the revolving cylinder spaced apart is a disassembled view.

In FIG. 31a an alternative embodiment of the cassette 127 is shown. Theview in FIG. 30a is similar to the view in FIG. 31a . In the embodimentin FIG. 31a a magazine 135 having a number of cylinders 129 storedtherein is provided. Hereby a cylinder 129 can by replaced by shiftingthe cylinders in the magazine 135. In one embodiment the cylinders areshifted by pressurized air or a motor. The filter is then first replacedin the blood flow passageway and thereafter in a position outside theblood flow passageway replaced in the cassette. Such a replacement couldpreferable take place by having a number of filters in the cylinder 135on one side of the cassette marked with 135 and moving the dirty filtersout from the cassette into the cylinder on the other side of thecassette.

In an alternative embodiment the cylinder 135 is instead a cleaningdevice adapted to clean the filter at a position outside the blood flowpassageway.

In FIG. 31b the cassette 127 is shown from the side with the supports131 and the revolving cylinder spaced apart is a disassembled view.

Please note that any embodiment or part of embodiment or feature ormethod or associated system or part of system described herein may becombined in any combination.

1-101. (canceled)
 102. A method of implanting a blood clot removal device in a patient's body, the method comprising: cutting the skin of the patient's body, dissecting an area of the patient's vascular system, placing the blot clot removal device at the dissected area, the blood clot removal device comprises a blood flow passageway having a first side wall and a second side wall, a filter provided in the blood flow passageway for filtering blood clots, a cleaning device for cleaning the filter configured to remove blood clots from the filter by moving blood clots along the filter from the first side wall toward the second side wall to move blood clots away from the blood flow passageway; connecting the blood flow passageway of the blood clot removal device to the patient's vascular system to allow circulation of the patient's blood through the blood flow passageway.
 103. The method according to claim 102, wherein the method is a surgical abdominal approach, and wherein the step of cutting the skin of the human patient comprises cutting the skin at the abdominal region of the patient.
 104. The method according to claim 103, further comprising the step of placing a blood clot removal device at the dissected area comprises placing a blood clot removal device in any part of the vascular system in the abdomen.
 105. The method according to claim 102, wherein the method is a surgical thoraxical approach, and wherein the step of cutting the skin of the human patient comprises cutting the skin at the thoraxical region of the patient.
 106. The method according to claim 103, further comprising placing a blood clot removal device in any part of the vascular system in the thorax.
 107. The method according to claim 103, wherein the method is a laparoscopic abdominal approach.
 108. The method according to claim 107, further comprising at least one of the steps of: inserting a needle or a tube like instrument into the abdomen of the patient's body, using the needle or a tube like instrument to fill the patient's abdomen with gas thereby expanding the patient's abdominal cavity, and placing a-the blood clot removal device in any part of the vascular system in the abdomen.
 109. The method according to claim 105, wherein the method is a laparoscopic thoraxical approach.
 110. The method according to claim 108, further comprising at least one of the steps of: inserting a needle or a tube like instrument into the thoraxical region of the patient's body, using the needle or a tube like instrument to fill the patient's thoraxical region with gas thereby expanding the patient's thoraxical cavity, and placing a-the blood clot removal device in any part of the vascular system in the thoraxical region.
 111. the method according to claim 102, further comprising the step of placing a source of energy in the patient's body for powering the blood clot removal device.
 112. The method according to claim 102, further comprising the step of programming the blood clot removal device from outside the body of the patient.
 113. The method according to claim 102, further comprising the step of non-invasively regulating at least one function of the blood dot removal device from outside the patient's body.
 114. The method according to claim 102, further comprising the step of wirelessly communicating with the blood clot removal device, non-invasively from outside of the body of the patient.
 115. The method according to claim 114, wherein the step of wirelessly communicating with the blood clot removal device comprises sending feedback information from inside the patient's body to the outside thereof, said feedback information being related to a functional parameter of the blood clot removal device or a physical parameter of the patient.
 116. The method according to claim 115, wherein the functional parameter of the blood clot removal device is correlated to the transfer of energy for charging the internal energy source.
 117. The method according to claim 111, further comprising the step of wirelessly charging the source of energy, after said source of energy has been implanted in the patient's body.
 118. The method according to claim 102, further comprising the step of transforming wireless energy into electrical energy inside the patient's body using an implanted energy-transforming device.
 119. The method according to claim 102, further comprising the step of moving blood clots away from the vascular system by means of the blood clot removal device.
 120. The method according to claim 102, wherein the mechanical cleaning device is movable in a direction perpendicular to the direction of the blood flow passageway.
 121. The method according to claim 102, wherein the cleaning device is adapted to slice, push, suck away or scratch away any clots from the filter.
 121. (canceled) 